Page 46 - Open versus closed Mandibular condyle fractures
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Chapter 2.2 Closed
CASE 1
A 57-year-old female patient presented with a mandibular condylar fracture on the left side and a paramedian fracture on the right side. Dental occlusion was disrupted with premature contact on the left side and a midline deviation to the left was seen when opening the mouth. Bilateral MMF with elastic bands was started with brackets on the cuspids and premolars.
After 2 weeks, the patient’s occlusion was corrected and the guiding elastics were discontinued. Four weeks post-trauma, the patient developed a malocclusion with premature contact at the molar region on the right side. Physiotherapy was initiated and 8 weeks after trauma occlusal stops were fitted. Four weeks after removal of the occlusal stops, a correct occlusion was achieved.
CASE 2
A 48-year-old male patient presented with a fracture of the left mandibular condyle. Intraoral inspection revealed a premature contact in the left molar region and an open bite on the right side. Brackets and firm elastics were placed on both sides of the maxillary and mandibular cuspids, premolars, and molars.
Three weeks post-trauma, the patient had no complaints of pain; however, a minimal malocclusion persisted and closed treatment was continued with guiding elastics. Nine weeks after trauma, a heavy contact between the molars on the left side was observed. At this point, occlusal stops were placed and physiotherapy was initiated. Six weeks later, the occlusal stops were removed and a correct occlusion was achieved, except for a minimal gliding tendency on the left side. Physiotherapy was continued, and 24 weeks after trauma, the occlusion was completely corrected.
CASE 3
A 79-year-old female patient appeared 3 weeks after fracture of the condylar head on the left side. A unilateral open bite of 3 mm on the right side was identified during examination. Closed treatment was initiated using brackets and firm elastics placed on the premolars and molars. One week later, the patient’s occlusion still did not improve, but the open bite was significantly reduced. Occlusal stops were placed and traction with elastics was continued.
 
























































































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